Safety in Chaos - Develop an Incident Command System for your Workplace

Organizational structures are the foundation in which most companies operate. Having clearly defined roles and responsibilities help the business environment typically run smoothly with the ability to quickly handle business issues which arise. However, this type of organizational structure doesn’t necessarily work well in the event of a medical emergency or something more significant such as a fire or natural disaster.

There is an organizational structure called the Incident Command System which was developed to help firefighters mitigate large scale wildland fires. It has grown and been adapted to work for police, EMS and even the corporate environment. Having an incident command structure developed for your workplace and employees trained in its use will ensure the chaos that comes with emergencies is handled in an effective, efficient and safe manner. Personnel who are tasked with assisting in the mitigation of emergencies will understand their role and responsibility not as it pertains to their normal work duties but those that occur during emergencies. Many companies have trained Emergency Response Team members as well as facilities personnel, security, environmental health and safety and others who should understand how they fit within an ICS structure.

FIRST IN Emergency Response Training specializes in working with companies to build Incident Command System structures to fit their corporate environment. The FEMA model of ICS doesn’t always work in the business environment but can be adapted and developed to fit the needs of the corporation. Using ICS in your company will help to ensure a quicker resolution and return to normal operating conditions when emergencies happen.

Resolve to make your workplace safer in 2016

Resolve to make your workplace safer in 2016

It’s not too late for a New Year’s Resolution! Most often these relate to our personal lives but why don't we set New Year’s Resolutions for our life within the workplace? 

As with all New Year’s resolutions, setting manageable goals and expectations is critical for success. Develop your plan for the year and follow through for a safe and prepared workplace environment.

Read More

What’s your emergency plan?

In today’s environment there are numerous types of major emergency incidents which may occur. It is critical not only have plans and preparations in place, but to test them as well. How does a manager of response and mitigation efforts at a company test procedures and preparations? An initial test is to conduct table top exercises with key personnel who will have many responsibilities during the incident. Whether you use an incident command structure or some other type of organizational structure to assist in controlling the chaos, it is important to evaluate. What information might be gained from this type of test? Given a specific scenario for your company you should be able to gather important information including potential hazards, vulnerabilities and impacts which might occur based on the incident. How will personnel respond under stress, what problem solving techniques work, how will you organize and structure a response with 10% of your employee population injured or needing assistance? Conducting initial table top exercises can be very effective in identifying areas of needed improvement.

Once table top exercises are running smoothly, a second step is to conduct a functional exercise. This can be as simple as a full evacuation to evaluate communications or sweeping techniques or it could include injured and trapped personnel, hazardous materials spills or leaks and other potentially challenging events. One company, in which we have been working with the last 7 years, has conducted annual full functional exercises. They started small and grew to conduct a full evacuation of all personnel at 2 sites simultaneously incorporating injured and trapped personnel, fires, hazardous materials incidents and so on. Every year they identified several instances where some event during the incident created a problem which was not preplanned for and problem solving became a priority.

At a minimum testing your plans, procedures and preparations will help you to grow and pre-identify key issues at your site to create a more positive and safe outcome.

The Care and Feeding of an Emergency Response Team

Many businesses and corporations have dedicated Emergency Response Teams, sort of….Often these businesses and corporations have the best intentions although for many it’s checking off a box by providing a basic CPR and First Aid class.  The reality is, building a team is more complex than a basic class once a year. A vibrant, effective and efficient Emergency Response Team requires care and feeding. First, it is important to look at why employees volunteer to set aside time out of their busy schedule’s to take training. For some it is not volunteer, it is a requirement of their job. For most, it is something they want to participate in for a variety of reasons. This may include the desire to help fellow employees in an emergency ( “be a part of the solution, not a part of the problem”), having the skills and knowledge to use at home and in their communities and an acquired skill set to add to their resumes`. If you are an EH&S, Security or Facilities manager in charge of an Emergency Response Team Program, here are a few simple suggestions to keep engagement.

  1. Hands-on, Interactive Training Classes – Who wants to sit through someone reading through PowerPoint slides or watching endless videos. Realistic, scenario-based training will keep students engaged and often wanting to know when the next class is being held.
  2. Communication – Emergency Response Team members need at a minimum monthly communications. This might include upcoming training offered, ERT brown-bag lunch events, new information concerning response procedures, or ERT safety fairs for the workplace. Staying in contact keeps the team informed and involved.
  3. Swag – There is nothing more powerful than having something someone else wants. Special ERT identifiers such as badges, t-shirts, hats and jackets with business and/or corporate logo’s with ERT identifiers often provide great incentive.

Whether your Emergency Response Team is new or well established, having a plan to keep your team engaged, interested and enthusiastic will limit the constant resuscitation of the program from the brink of death…

First Aid in the Workplace – It’s not what it used to be…

There are many skill levels associated with providing “first aid” in today’s workplace. They can range from basic course components like CPR, controlling bleeding and managing choking to heat stroke, shock and allergic reactions. However, in today’s workplace, Emergency Response Teams have developed a more advanced level of emergency response to aid ill and injured employees by providing emergency oxygen, assessing vital signs and even providing a patient care report to professional responders.

Often advanced medical training can also include wound care, bandaging, and splinting. Some teams are even trained to conduct a SAMPLE history identifying allergies, medications, past medical history and other information to pass on to professional responders.

Depending on the investment of the small business or large corporation, Emergency Response Teams can be trained to numerous levels. A minimum level of training including CPR, First Aid and the use of the Automated External Defibrillator should be provided to employees who want to respond to workplace emergencies. Depending on the size of the employee population, location of nearest fire station or EMS post, and any manufacturing processes of the business, more advanced levels of training may be beneficial.

Triage - Emergency Response in Corporate America

The word “Triage” comes from the French verb “trier” meaning to separate, sort or select. Its early foundation is thought to have originated during the Napoleonic Wars from the work of Dominique Jean Larrey. It was then further used during WWI by French doctors in the battlefield.

Triage is used in today’s emergency response field to “sort out” patients during mass casualty incidents. The emergency response field includes Emergency Response Teams in business and corporate environments. Incidents which often involve injuries to large quantities of people include airline crashes, rail transportation accidents, multiple vehicle accidents, and here in the bay area, earthquakes.

Let’s assume you are the safety manager for a building of 300 employees.  If just 10% of that employee population was injured in an earthquake, 30 employees, how would you decide which employees to provide first aid to first?  Now think about a corporation such as TESLA with an employee population of almost 8,000 employees in Fremont. 10% is 800 injured employees, so where do you begin?

Today’s Traige has been refined to assess 3 critical elements during patient assessment.  They include Respirations, Perfusion, and Mental Status (RPMs). Based on those initial assessments, employees can be provided care based on categorizing the injured into Immediate, Delayed, and Minor groupings.

Triage is simple to learn, and FIRST IN encourages any business or corporate emergency response team to include triage as a part of their training curriculum.

Shelter in Place - S-I-P: Do You Know How?

S-I-P is a term not commonly heard related to Emergency Response in the workplace. Corporate America has fine-tuned the art of Emergency Evacuation establishing assembly areas, accountability check lists, and organizational structures to manage the chaos but very few practice or have even developed procedures for Shelter-In-Place.

Many of the companies where I conduct training are within a ¼ mile of a major highway.  Hazardous Materials are transported daily on these highways as well as railroad tracks which are also near many corporate buildings.  Typically, when an emergency evacuation is necessary, most buildings have sirens and strobe lights to indicate to employees an evacuation of the building is needed.  However, what notification systems are in place for your site to notify your employees of a shelter-in-place activation?  Is there an intercom system? Do you have Send Word Now software to notify employees via phone, text or email?  Within your structure, where will you shelter-in-place to ensure you are away from doors and windows?

These are just a few of the questions I ask my clients when reviewing Emergency Response Plans and Procedures.  For 2015 I will be working closely with my companies to ensure they have solid procedures in place if a Shelter-In-Place Activation is needed.

Here are just a few suggestions from the Department of Homeland Security:

At Work:

  • Bring everyone into the room(s). Shut and lock the door(s).
  • If there are customers, clients, or visitors in the building, provide for their safety by asking them to stay – not leave. When authorities provide directions to shelter-in-place, they want everyone to take those steps now, where they are, and not drive or walk outdoors.
  • Unless there is an imminent threat, ask employees, customers, clients, and visitors to call their emergency contact to let them know where they are and that they are safe.
  • Turn on call-forwarding or alternative telephone answering systems or services. If the business has voice mail or an automated attendant, change the recording to indicate that the business is closed, and that staff and visitors are remaining in the building until authorities advise it is safe to leave.
  • Close and lock all windows, exterior doors, and any other openings to the outside.
  • If you are told there is danger of explosion, close the window shades, blinds, or curtains.
  • Have employees familiar with your building’s mechanical systems turn off all fans, heating and air conditioning systems. Some systems automatically provide for exchange of inside air with outside air – these systems, in particular, need to be turned off, sealed, or disabled.
  • Gather essential disaster supplies, such as nonperishable food, bottled water, battery-powered radios, first aid supplies, flashlights, batteries, duct tape, plastic sheeting, and plastic garbage bags.
  • Select interior room(s) above the ground floor, with the fewest windows or vents. The room(s) should have adequate space for everyone to be able to sit in. Avoid overcrowding by selecting several rooms if necessary. Large storage closets, utility rooms, pantries, copy and conference rooms without exterior windows will work well. Avoid selecting a room with mechanical equipment like ventilation blowers or pipes, because this equipment may not be able to be sealed from the outdoors.
  • It is ideal to have a hard-wired telephone in the room(s) you select. Call emergency contacts and have the phone available if you need to report a life-threatening condition. Cellular telephone equipment may be overwhelmed or damaged during an emergency.
  • Use duct tape and plastic sheeting (heavier than food wrap) to seal all cracks around the door(s) and any vents into the room.
  • Write down the names of everyone in the room 

S-I-P is a term not commonly heard related to Emergency Response in the workplace. Corporate America has fine-tuned the art of Emergency Evacuation establishing assembly areas, accountability check lists, and organizational structures to manage the chaos but very few practice or have even developed procedures for Shelter-In-Place.

Many of the companies where I conduct training are within a ¼ mile of a major highway.  Hazardous Materials are transported daily on these highways as well as railroad tracks which are also near many corporate buildings. Typically, when an emergency evacuation is necessary, most buildings have sirens and strobe lights to indicate to employees an evacuation of the building is needed.  However, what notification systems are in place for your site to notify your employees of a shelter-in-place activation? Is there an intercom system? Do you have Send Word Now software to notify employees via phone, text or email?  Within your structure, where will you shelter-in-place to ensure you are away from doors and windows?

These are just a few of the questions I ask my clients when reviewing Emergency Response Plans and Procedures. For 2015 I will be working closely with my companies to ensure they have solid procedures in place if a Shelter-In-Place Activation is needed.

Here are just a few suggestions from the Department of Homeland Security:

At Work:

Keep listening to the radio or television until you are told all is safe or you are told to evacuate. Local officials may call for evacuation in specific areas at greatest risk in your community.

Close the business and call your business’ designated emergency contact to report who is in the room with you, and their affiliation with your business (employee, visitor, client, customer.)

The New “First Responder”

Firefighters, Police Officers, and Paramedics have always been thought of as the first trained teams on scene to render aid in an emergency. However, with cutbacks in city emergency personnel, fire station closures resulting in larger geographical response areas, expecting professional emergency responders to arrive as quickly as before is not a given anymore. A typical average response time of 3-6 minutes in some areas now takes much longer, over 10 minutes in some locations. Minutes and even seconds count if someone is not breathing, is severely bleeding, or experiencing any number of emergency incident scenarios.

Out of a need to fill the gaps created with these changes, has come a new breed of “FIRST RESPONDER” which includes Community Emergency Response Teams (CERTS) as well as Emergency Response Teams for the Business and Corporate environment. These business Emergency Response Teams provide a valuable benefit for their company by providing an immediate response to all types of emergency situations including; fire (evacuation), medical incidents, hazardous materials spills, and disaster mitigation. These trained teams (often volunteer) provide immediate on scene management of all types of emergencies in the workplace until professional responders arrive. On some occasions, minutes really do make the difference.  

As a retired firefighter, I have witnessed first hand the benefit of having workplace emergency response teams in place. The control of severe bleeding, performing bystander CPR, a safe and orderly emergency evacuation, all potentially contribute to the best possible outcome. And the benefit to the company itself may include: lower insurance premiums, lower worker’s compensation payouts, and a quicker resumption to normal business operations. These specially trained employees often provide an atmosphere of positive business morale and a sense of workplace camaraderie.

One additional benefit, which is often overlooked, is that emergency response trained employees take their skills out into the world, providing a means to render aid to their family and friends, and their community at large. The new “First Responder” is a valuable asset not only to their workplace but to the population in general. The reality everyone is facing is the fact we, as a society in general, must adopt a preparedness mentality and become more self-sufficient as professional responders may not arrive in time to provide care when minutes can make the difference.

A Fortune 500 Company Prepares for Disaster Part One

Preparation is the key to a more successful outcome related to emergency response in the workplace. This includes a pro-active approach to preparing for emergencies of all kinds such as illness and injury, emergency evacuation and disaster response. Preparation should always include realistic hands-on training scenarios. At FIRST IN Emergency Response Training, we are strong proponents of this type of training methodology. Students learn best by doing, by thinking on their feet, by being challenged with changing conditions during an emergency.

During the month of April FIRST IN conducted two large scale disaster drills for a Fortune 500 company in the Bay Area whose campus encompasses 10 buildings and 9,000 employees. This company supports an in-house Emergency Response Team who participated in an 8 week Search and Rescue training course (similar to a CERT program), concluding with a hands-on disaster drill. A request was sent to area CERT (Citizen/Community Emergency Response Team) members asking for volunteers to participate as victims for the upcoming drills. These CERT members often comment on how much they learn as victims and they provide excellent feedback to the Emergency Response Team members who provided their rescue.

Victims were moulaged (provided realistic injuries with make-up) including lacerations, contusions, head injuries, fractures, puncture wounds, etc. They were given a briefing on how to act related to their injuries which included crying, hysteria, confusion, anger, disorientation and more. Victims were placed under desks and tables, in bathrooms and closets and in stairwells throughout several buildings on campus and waited for their would-be rescuers.

The Search and Rescue team at this company follows an emergency response organizational structure known as the Incident Command System. It allows for a more coordinated effort in controlling the chaos a large scale emergency can create. Trainers and Safety Officers at FIRST IN provided the scenario as the drill began:

It is 4:15pm on a Wednesday in mid-December. Temperature is 55 degrees with winds WSW at 12mph. There is a chance for rain in the evening. A 7.1 magnitude earthquake has struck the Hayward fault with a secondary earthquake of 6.4 hitting the San Andreas fault. Powerlines are down leaving your campus without electricity. Cell phone towers are out so you have no cell phone or landline capabilities. Highways and overpasses are severely damaged so leaving by vehicle is not possible. Thousands of employees are beginning to evacuate from your buildings, many with injuries and showing signs of shock. They are looking to you for help and guidance. The emergency response system (911) is overwhelmed and it may be days before help arrives. Begin your response…

How did they respond? Who was in charge? What were their priorities and what kind of challenges did they encounter? What were the lessons learned?  Find out more in Part Two.

Disaster Response in the Workplace

It’s 4:15pm in mid December and a 7.1 magnitude earthquake strikes the Hayward Fault in California. Powerlines and cell phone towers are down leaving thousands without the ability to communicate to emergency response personnel or family. Roadways are damaged leaving thousands unable to get home or find safe refuge. It will be dark soon with the temperature dropping, maybe even rain. Buildings are damaged making it  unclear if your building is safe to reenter with the possibility of aftershocks of great concern. The professional response system is overwhelmed and help may not arrive for days. You have 1000 employees at your workplace looking to your company for food, water, sanitation, medical care and shelter. Are you prepared to handle this type of disaster response in your workplace?

The lack of a well-developed disaster plan may expose an employer to administrative penalties and claims of negligence in the event of a disaster in which employees are injured or killed. OSHA requires employers to have emergency action plans in a wide variety of situations and to communicate the plans to employees. The OSHA regulation on this subject specifies minimum elements of the plan, including procedures for reporting fires or other emergencies, evacuation procedures, procedures to be followed by employees who remain on-site, procedures to be followed for accounting for employees after evacuation, and training of employees. Failure to comply can result in administrative fines. Possible liability claims might arise from the absence of an emergency plan, inadequacy of a plan, and failure to follow the plan.

Many corporations have disaster plans in place with supplies, trained employees and an organizational structure in place to support a mitigation effort. A well-conceived disaster management plan including rehearsal of the plan may help reduce the risk of liability in the event of a disaster. These types of preparations would demonstrate good-faith efforts to comply with legal requirements.

Prepare your workplace for natural or man-made disasters.  Be self-sufficient, promote and support in-house volunteer emergency response teams and have a plan!

Thoughts on Compression Only CPR

There has been a recent media push regarding a concept introduced by the American Heart Association called, “Compression Only CPR.” This means that bystanders who volunteer to assist someone who is unresponsive and not breathing should begin chest compressions and continue chest compressions without breathing for the victim.

I understand the concept, as for many lay rescuers who have not taken a CPR class or do not want to place their mouth on the mouth of an unknown individual, compression only CPR is a good alternative. However, one key element with Compression Only CPR is that it is most effective when performed on ‘witnessed’ arrests (where the patient goes down in front of the rescuers). This is because research shows in sudden cardiac arrest there is still ample oxygen in the lungs and blood, and immediate chest compressions will keep that oxygenated blood flowing to the heart and other vital organs.

What happens to the victim of a cardiac arrest which was not witnessed and the amount of time passed is unknown? This circumstance is not addressed with Compression Only CPR guidelines. Concrete evidence shows tissue damage begins after 4 minutes to a brain without oxygen, and after 10 minutes of no oxygen, significant brain death has occurred. For a witnessed arrest, once the oxygen in the body has been depleted, what then? Firefighters and ambulance personnel have barriers to protect themselves when providing rescue breaths. However, the basic lay rescuer may not have a personal barrier with them in the event of an emergency.

I encourage all individuals both professional and lay responders trained in CPR to carry personal protective barriers. They can be found on many sites but one of my favorites is the Microshield Key. It is a CPR barrier on a key chain because I always have my keys with me when I am not at home.

Be prepared and stay safe!